Continuum of care and survival in patients with metastatic colorectal cancer: results of the real-world prospective, longitudinal cohort PROMETCO study

Background: PROMETCO is the first international, prospective study investigating the continuum of care, including prescribing patterns, efficacy and safety in patients with metastatic colorectal cancer (mCRC) at later therapy lines in a real-world setting. Materials and methods: Adults with mCRC and two disease progressions since diagnosis of mCRC who were willing to receive subsequent treatment and gave informed consent were included. The study consisted of retrospective medical chart data collection pre-inclusion and a prospective observational period post-inclusion. Endpoint data presented include patient characteristics, treatment patterns and efficacy including progression-free survival (PFS) per treatment line and overall survival (OS). Results: As of July 2023, 738 mCRC patients from 96 centres in 18 countries were recruited. 48.9% of patients had RAS-mutated and 5.0% BRAF-mutated mCRC. Between mCRC diagnosis and death or withdrawal, patients were frequently exposed to fluoropyrimidine (99.0%), irinotecan (96.2%), oxaliplatin (88.4%), anti-vascular endothelial growth factor (78.7%) and anti-epidermal growth factor receptor (40.1%). Median OS was 36.4, 7.1, and 6.6 months from mCRC diagnosis, inclusion into PROMETCO and third-line (3L) treatment initiation, respectively. Median PFS decreased significantly from first-line (9.2 months) to 3L (2.7 months) and remained consistent from 3L to sixth-line treatment (∼2.3 months). Median OS from diagnosis was 32.7, 26.8, and 40.6 months in RAS-mutated, BRAF-mutated, and RAS/BRAF wildtype mCRC patients, respectively. Conclusions: PROMETCO provided information on real-world prescribing patterns and efficacy. OS from mCRC diagnosis and PFS from 3L and beyond were similar to previous long-term follow-up data from clinical trials.